Gathering, storing, and retrieving summary electronic healthcare record information from healthcare providers

ABSTRACT

The system and method of the invention describes a unique approach to gathering patient treatment information in summary form from a universe of health care providers, each using any form of patient information management; converting that information to pointers that can be searched by a healthcare provider before or during treatment to determine if further information needs to be acquired from the original provider; and a variety of methods to provide access to detailed healthcare treatment and diagnosis information from the original healthcare provider through an access and display method provided by the healthcare provider housing the records, if available. The system and method envisages one or more providers of repository services, each offering various ways for healthcare providers to update and maintain summary information, and each providing for continual exchange of information among them to ensure complete access to all available information.

A portion of the disclosure of this patent document contains materialwhich is subject to copyright protection. The copyright owner has noobjection to facsimile reproduction by anyone of the patentdocumentation or the patent disclosure, as it appears in the Patent &Trademark Office patent file or records, but otherwise reserves allcopyright rights whatsoever.

FIELD OF THE INVENTION

The field of the invention relates to medical record search andretrieval, the management of patient record information, and diagnosticservices for healthcare providers.

BACKGROUND OF THE INVENTION

Healthcare providers manage patient treatment information in a varietyof forms, ranging from completely automated electronic healthcare recordmanagement systems to paper files. Discovery of possibly significantinformation about a patient is ineffective and likely to be incompletesince most patients utilize a variety of providers which in turn utilizea variety of incompatible record management systems. Searching formedically relevant records for a particular patient is hampered by thenumber of previous healthcare providers that have treated a patient, andlikely to be dangerously incomplete. A recent US government initiativeto compel all healthcare providers to implement electronic healthcarerecord management systems by 2014 does not address and will not solvethe problem of identifying all previous treatment and diagnosisinformation.

There are numerous reasons why a simple search of the web using Google,Bing, Yahoo or any other search engine would not provide equivalentresults to the invention. First, search engines focus on publicinformation openly displayed on searchable pages. A search for a patientidentifier such as its social security number (“SSN”) might returnthousands of records containing that number in completely unrelated webpages, even assuming that the medical record information were exposedand indexed by search engines. But health care records must be protectedby adequate security, behind at least password protected barriers. Inorder to search electronic health care record systems each search enginewould have to have gained access to those systems with appropriatesecurity measures. Consequently, simple searchers would have to beparticularized to specific web sites corresponding to health careproviders, which is a feature of the invention but not available insearch engines since they assume they will search all web pages notrestricted by the convention “nosearch” on the page URL.

Second, even if search engines had particularized, security controlledaccess to a defined set of health care provider systems, the patientidentifier would not necessarily be the first information in a record,or in a standard location. The search engines would have to do a deepsearch of every record in every system looking for all occurrences ofthe patient identifier or SSN. This would depend on patient identifiernumbers being readily found and identified, and could also returnrecords for dependents, parents, or other relatives included, meaningthat the results of the search could be incomplete or overloaded withpossibly extraneous records. Information on date of service anddiagnostic code or prescription information would also have to bededuced from the contents of each record.

Third, results returned would be incomplete since the majority of healthcare providers have not converted to electronic health care recordsystems, and have no medical record information to offer up to a searchengine. A federal requirement is that all health care providers must usesuch systems by 2014, but there is no requirement for providers toconvert all older records. Consequently, even if a particularized searchwas available, and patient identifiers could identify records ofinterest, this would not reach all health care providers until 2014 atthe earliest, and would not necessarily provide records of previoushealth care records.

Finally, even if there were a particularized and secure search of healthcare providers available, and even if the basic information of patientID, date of service and diagnostic code could be found by searchingrecords, and even if all health care providers had converted toelectronic record management systems, and even if those records could bereturned in a consistent form, the variety of electronic health carerecord formats would make the results difficult to scan for particularinformation, difficult to search in date order, and difficult to easilydetermine which records may be of interest based on the diagnostic ortreatment code, since records and record fields will vary from system tosystem.

SUMMARY OF THE INVENTION

The system and method of the invention contemplates one or morerepositories of medical record information, or Medical RecordsRegistration and Management systems, such as repositories, to compilesummary patient treatment and diagnosis information that can serve aspointers or references from any and all Health Care Providers,containing at a minimum unique patient identifiers (Social SecurityNumber or alien identifier), date of service, Health Care Provideridentifier, diagnostic code or diagnosis, and optionally billing codesassociated with the provision of health services.

In addition, each repository would contain or have access to a databaseof Health Care Providers, current and past diagnostic codes and billingcodes, and information or technical indicators determining whether theHealth Care Provider electronic system of Electronic Healthcare Records(if any) could be accessed directly by another Health Care Provider.

The method of the invention would allow for a rapid search of allrepositories, including Health Care Providers that act as their ownrepository of information, to find all Electronic Healthcare Recordspointers or references and summaries, arranged by date. A Health CareProvider providing service to a patient could determine which recordsmight be needed to properly treat the patient by date of service anddiagnosis, and possibly billing code. If the Health Care Provider withthe patient Electronic Healthcare Records has a direct or browser basedaccess to those records, the Health Care Provider could access themdirectly.

The system and method is completely general in that it allows for amultitude of repositories, does not require a massive and expensiveconversion to a common system to improve health care management(reference to failed UK electronic healthcare records system),encourages new and increasing effective ways to store and retrieveelectronic healthcare records without reducing the effectiveness of theinvention, allows for security and HIPAA compliance processes now inplace or that may be defined to be incorporated, and places patienthealth care uppermost.

The system and method is unique and unprecedented in that it reversesthe thinking that all Electronic Healthcare Records would need to betranslated into a common standard format, and possibly centralized toachieve uniform and complete access to electronic healthcare records.That approach would require years if not decades to implement in anymeaningful way, i.e. comprising more than 80% of electronic healthcarerecords, and would depend on the time consuming and usually contentiousprocess of setting industry standards for electronic healthcare records.

Instead, the system and method of the invention simply provides apointer to electronic healthcare records and where the detailedinformation in the electronic healthcare records are stored, along withbasic information to allow healthcare providers to determine whether theelectronic healthcare records may be relevant, and whether they may beaccessed in some electronic form, or must be accessed through lessefficient means such as fax or even phone conversations.

Additional features and characteristics of the invention are that it is:(a) Based on the point of view of the recipient of medical treatment,the patient, and the immediate healthcare provider, to maximize thevalue of electronic healthcare records in treating the patient; (b)Provides for organization and identification of medical data, recordsand information (electronic healthcare records) without specific actionby the patient; and (c) Allows for registration by Social SecurityNumber or Alien registration number as a universal identifier.

Specific Attributes of the Invention include: (a) pointer records orreference data may be transferred in their entirety by the originalhealthcare providers to one of many providers of electronic healthcarerecords based on Social Security Number or unique identifier; (b)healthcare providers may choose to record that patient electronichealthcare records are stored on their system and are available foraccess, transfer and/or review with proper access rights established;(c) existence of electronic healthcare records can be established atone, some or all of the providers of Medical Records Registration andManagement repositories; (d) repository providers can accept records inmultiple formats according to their capabilities, or only record theprovider identification and the access path for the records; (e)repository providers may allow for PDF documents, scanned images,recordings, faxes, lab results in many electronic forms, and othercurrent or future available formats; (f) does not require a singlecentralized provider of medical information, and in fact would encouragecompetition to act as a repository; (g) does not require translation orconversion of electronic healthcare records into some standard format,thus allowing all existing systems to continue in use without expensiveupgrades; (h) Allows for redundancy of storage for electronic healthcarerecords across providers of repositories; and (i) encourages electronichealthcare records providers and software providers for the medicalmarket to establish common access processes or APIs that would allowmedical practitioners to access patient information without regard tothe system containing the information.

The method of the invention provides a simple and easily implemented wayfor any and all health care providers to indicate the existence ofrecords for a patient, without necessarily having to convert old recordsfrom paper, and without requiring all health care providers to haveelectronic record keeping systems in order to indicate the availabilityof patient information. The invention provides a consistent, powerfuland complete approach to gathering and presenting summary records, orpointers, to possibly relevant information contained in a multiplicityof forms by all health care providers regardless of which if anyelectronic record keeping system they have.

Numerous advantages and features of the invention will become readilyapparent from the following detailed description of the invention andthe embodiments thereof, and from the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

A fuller understanding of the foregoing may be had by reference to theaccompanying drawings, wherein:

FIG. 1 is a general schematic overview of the invention illustrating theconnection between repository databases and healthcare providers;

FIG. 2 is a general schematic overview of healthcare providers beingcapable of updating patient information medical links; and

FIG. 3 is a general schematic overview of an example of a request forpatient record information made by an healthcare provider.

DETAILED DESCRIPTION OF THE INVENTION

While the invention is susceptible to embodiments in many differentforms, there are shown in the drawings and will be described herein, indetail, the preferred embodiments of the present invention. It should beunderstood, however, that the present disclosure is to be considered anexemplification of the principles of the invention and is not intendedto limit the spirit or scope of the claims by the embodimentsillustrated.

The following terms are used herein with their accompanying definitions:

Repository (Database)—one or more structured sets of persistent data,usually associated with software to update and query the data. A simplerepository might be a single file containing many records, each of whichis structured using the same set of fields. A repository can comprise amap wherein various identifiers are organized according to variousfactors, such as identity, physical location, location on a network,function, etc.

Active Link—a link on a page that allows a user to access a particularfunction by activating the active link through an action such as akeyboard stroke or mouse click. Activation of an active link can occurthrough a “single action”, which as used herein refers to any single actthat can activate a function, such as a mouse click, a mouseover, akeyboard stroke, a pen stroke, a finger stroke or signal, a voicesignal, staring at a predetermined screen location for a predeterminedtime, and/or any equivalents thereof.

Identifier—a group of symbols that are unique to a particular entity,activity, and/or document. An identifier can be, for example, a medicalrecord number. An identifier can be human and/or machine readable, suchas for example, a number, an alphanumeric string, a bar code, an RFID,etc.

Patient or Healthcare Identifier or ID—an identifier for a particularpatient or healthcare organization. A patient identifier might be asocial security number, taxpayer ID number, national ID number, Medicarenumber, Medicaid number, medical insurance ID number, medical recordnumber, etc. A Healthcare Provider Identifier or ID might be a tax orFEIN number, etc.

Repository identifier—an identifier for a particular respository towhich one or more patient monitoring devices are linked.

Information device—a device capable of processing information, such asany general purpose and/or special purpose computer, such as a personalcomputer, workstation, server, minicomputer, mainframe, supercomputer,computer terminal, laptop, phone, and/or any equivalents thereof, etc.

Interface—a boundary across which two independent systems meet and acton or communicate with each other. To connect with or interact with bymeans of an interface.

Machine-readable media—a memory readable by an information device.

Memory—a device capable of storing analog or digital information, forexample, a non-volatile memory, volatile memory, Random Access Memory,RAM, Read Only Memory, ROM, flash memory, magnetic media, a hard disk, afloppy disk, a magnetic tape, an optical media, an optical disk, acompact disk, a CD, a digital versatile disk, a DVD, and/or a raidarray, etc. The memory can be coupled to a processor and can storeinstructions adapted to be executed by processor according to anembodiment disclosed herein.

Network—a wired and/or wireless communication network.

Network interface—a telephone, a cellular phone, a cellular modem, atelephone data modem, a fax modem, a wireless transceiver, an Ethernetcard, a cable modem, a digital subscriber line interface, a bridge, ahub, a router, or other similar device.

Patient—a human or other type of animal under supervision for healthcare purposes.

Patient or medical information—information relevant to the medical careand/or treatment of a patient, including real-time vital, biological,and/or physiological data, near real-time and/or prior history datarelating to vital, biological, and/or physiological data, blood pressureparameters, ventilation parameters, vital sign parameters, blood oxygenconcentration representative parameters, infusion pump parametersassociated with fluid delivery, drip medication related parameters,blood gas parameters, insurance information, health care personnelinformation, health care organization information, billing information,family information, financial information, therapy information, druginformation, and/or any equivalents thereof, etc.

Processor—a device and/or set of machine-readable instructions forperforming a task. A processor comprises any one or combination ofhardware, firmware, and/or software. A processor acts upon informationby manipulating, analyzing, modifying, converting, transmitting theinformation for use by an, executable procedure and/or an informationdevice, and/or routing the information to an output device. A processormay use the capabilities of a controller.

Server—an information device that provides some service for otherinformation devices connected to it via a network. A common example is afile server, which has a local disk and services requests from remoteclients to read and write files on that disk. A server can also provideaccess to resources, such as programs, shared devices, etc.

Uniform resource locator (URL)—a standard way of specifying the locationof an object, such as a web page, on the Internet, a network, and/or aserver connected thereto. A URL can comprise a data field that comprisesone or more identifiers.

User interface—a device and/or program for rendering information to auser and/or requesting information from the user. A user interface caninclude textual, graphical, audio, video, animation, and/or hapticelements.

User—an individual capable of utilizing a system for accessing patientinformation.

This section describes in general form the computer programs needed toimplement a comprehensive national data base of health care recordinformation. Any competent practitioner in field of informationtechnology could construct a system using this description.

The principal idea of the system of the invention conceives a multitudeof healthcare record repositories that would contain constantly updatedpointers or vectors that signify the existence of information on apatient, and sufficient information for a health care professional toaccess the information online (if the originating healthcare provideroffers online access) or to provide standardized request processes forasking for the records.

The descriptions below outline how the necessary computer programs wouldneed to be constructed by a normally competent programmer or systemsdevelopment company. Access to information within the repositories wouldbe controlled and limited according to accepted computer securitymethods and consistent with any applicable government regulations andcontrols. These security controls are assumed to be readily availableand are not described.

Basic Information Contained in Repositories

For every patient and every treatment event, diagnostic test or medicalprocedure, a summary record is created by the original HealthcareProvider (HCP) with the following basic information: (a) HealthcareProvider Identifier, (b) Patient ID, (c) Date of Service, and (d)Diagnosis and/or Billing code. The Healthcare Provider Identifier is aunique identification number that helps to identify the HealthcareProvider from each other Healthcare Provider. The Patient ID, may be thepatient's SSN or another alien identification number, identifies thepatient from other patients, and from related family members. TheDiagnosis and/or Billing Code are codes widely used in the medical fieldhelp to identify the type of treatment, procedure, or tests, conductedby the Healthcare provider.

These records are referred to as pointers or vectors because they serveto locate more detailed information about the patient, the healthcareprovider, and health care information available including test results,recordings, radiology scans, etc. These records are further stored onmemory in a Repository or Database.

Every Healthcare Provider (HCP) can select from a multitude ofRepository service providers (REP) that maintain one or moreRepositories to accept and maintain the HCP record pointers. Theselection would be based on any commercial basis including cost and easeof use for the HCP staff. The existence of multiple suppliers acting asRepositories will encourage competition and innovation, as opposed to asingle, central repository whether privately operated or governmentalsuch as SSA.

Automated, semi-automated or manual data entry programs gather the datafrom each HCP and transmit the data to a dedicated REP, which in turnshares that information with all other REPs using a process similar tohow search databases operate or using standard information exchanges.REPs maintain a database listing all other REPs along with accessinformation to allow secure exchange of healthcare record pointers amongREPs. REPs scan all other REPS on a periodic basis to compile a databaseof all healthcare record pointers. Each REP has comprehensive, up todate information available to the HCPs to which they provide service.REPs also maintain databases of billing codes (current and previous),and indicators about how records in each HCP can be viewed or accessedby another HCP, i.e. access method to be employed to see detailedinformation, electronic records, even x-rays and EKGs if available fromthe original provider. REPs may provide additional services to HCPsincluding maintaining original healthcare records and test results,providing interface programs to allow for automated collection andtransmission of healthcare records, and access programs that allow HCPstaff to directly access healthcare records at other HCPs using specialpurpose programs that do not require detailed information about otherHCP systems. These programs may be direct view or direct access or maybe browser based.

As illustrated in FIG. 1, a general description of the system and methodfor multiple repositories and health care providers is illustrated. Forexample, every Healthcare Provider Selects a Repository Provider to actas an Intermediary to any other Healthcare Provider searching forpatient records. In this example diagram, Dr. John Patterson (box 100)has selected (line 110) Repository A (box 120) to be its provider ofrecord pointers and its access point to search for and view health carerecords for its patients. Repository A (box 120) also provides servicesto Northwestern Hospital (box 130) and Union Memorial Hospital (box140), among others, as indicated by the ellipsis (dots 135). RepositoryN (box 150) provides services to Drs. Smith (box 160) and Kastner (box170) among others (dots 165). Other Respositories (box 180) would belinked to other HCPs (box 190). Each health care provider (100, 130, 135140, 160, 165, and 170) is typically already assigned or would beassigned an unique HCP identifier (102, 132, 142, 162, 172,respectively) and exchanges information with their selected repository(120, 150) including record pointers and in some cases copies of medicalrecords for storage on the repository.

Major Processes

These are four major processes or computer programs involved inimplementing the method of the invention. Each process could have manypossible specific implementations, much as there are 10 or morecommercially available web browsers, each implemented in a differenttechnical form but each providing the same basic service with similarfeatures and advantages. The four processes are: (a) Update HealthcareProvider Record Pointers in Repository HCP->REP; (b) Exchange Repositoryrecords with all other Repositories REP<-->REPS; (c) Search for PatientRecords in the Repository HCP<-->REP; and (d) Obtain detailedinformation about particular records HCP<-->REP<->HCP.

Update Healthcare Provider Record Pointers in Repository HCP->REP

Four program types would be available depending on the healthcarerecords management technology employed by a HCP. (1) Direct interfacefrom HCP to REP; (2) Automated extract of HCP record pointers and uploadto REP; (3) Manual data entry of HCP record pointers and upload to REP;and/or (4) Online data entry of HCP records into REP database.

In a Direct Interface from HCP to REP, the following steps would betaken: (a) Schedule daily or more frequent review of all of HCP recordsidentifying all records that have been created or changed since the lastreview; (b) Build upload file with all new or changed records instandard format (Note: upload file could be a complete refresh ofinformation to REP, even if technically inefficient, to ensure completeinformation exists on REP); (c) Prepare list of records that needdiagnostic code or additional information; (d) If any records areincomplete, display list to HCP administrator, schedule additionalreview of all records; and (e) Send upload file to REP. This can be doneover a direct or dedicated network connection between the HCP and REPrepository.

In an Automated extract of HCP record pointers and upload to REP, thefollowing steps would be taken: (a) Receive request from REP for updateinformation or complete refresh of all HCP information. (Note: thisprocess could also be scheduled for daily or more frequent review of allof HCP records identifying all records that have been created or changedsince the last review); (b) Run export data preparation program,customized for each type of HCP system, to review all record informationto ensure it is complete (Note: export file could be complete refresh ofall information to REP as noted above); (c) Prepare list of records thatneed diagnostic code or additional information; (d) If any records areincomplete: (i) Display/print list to administrator; (ii) Wait forsignal that records have been updated; (iii) Return to Step b; and Sendexport file to REP. This can be done over a network connection betweenthe HCP and REP repository. In some instances the HCP would log onto aserver and initiate a connection link between the HCP and REP and theninitiate data transfer.

In a Manual data entry of HCP record pointers and upload to REP, thefollowing steps are followed: (a) REP schedules daily or more frequentemail to HCP; (b) HCP receives email and starts local program to enterinformation; (c) HCP enters record information for new or changedrecords; (d) HCP uploads information to REP; (e) REP checks each recordfor completeness or duplicates; (f) REP returns error listing to HCP;and (g) HCP corrects errors and uploads information to REP.

Lastly, an Online data entry of HCP records into REP database, wouldinclude the following steps: (a) REP schedules daily or more frequentemail to HCP; (b) HCP receives email and clicks on link to enter datadirectly in REP system; (c) HCP enters record information; (d) REPchecks each record for completeness or duplicates; (e) If incomplete orduplicate, REP shows error message to HCP, HCP corrects record; and (f)REP stores information.

Exchange Repository Records with all Other Repositories Rep<-->Reps

Every Repository maintains a database of all healthcare records byregularly exchanging information with all other repositories, using adata base of repositories to scan for information. This process issimilar to how search engines use bots to scan all websites for new webpages or information. The principal difference is that the informationto be searched is behind a security screen and not available for generalsearch or access without the appropriate security controls. Theinformation is also in standard form, making the search and assembly ofinformation and information exchange straightforward.

Employing a typical search process against all HCPs would only gatherinformation from those with automated systems. This process provides ameans to gather information from all HCPs regardless of how or whetherthey employ automated records management systems.

Nevertheless, search bots are one of many possible methods to gather andexchange healthcare records with other repositories. Rather thandescribe the process used by search bots, it suffices to say that eachrepository would employ search bots to scan every repository listed inthe data base of repositories and retrieve all new or changed records.Each repository would need to maintain data base pointers that identifyrecords by date and time entered or changed so that other searchrepositories only need to retrieve that information and not all records.Again, similar methods are used by search bats to avoid retrievingunnecessary data.

Search for Patient Records in the Repository HCP<-->REP

Each repository could have a different interface or browser based methodof allowing a HCP to query the data base of records in the repository.The basic process would be: (a) Obtain patient ID—Social security numberor Alien ID; (b) Scan database for records for that patient ID; (c)Return list in date order; and (d) For each record, indicate whether HCPcan provide online access to further information.

Obtain Detailed Information about Particular Records HCP<-->REP<-->HCP

Medical records management systems have a local display method, oftenhighly customized to the system itself and requiring extensive trainingto use effectively to obtain and display patient information. Vendors ofthese systems would be encouraged to provide a standard means ofdisplaying information to other HCPs using browser based tools andreadily available display methods. New and improved records managementsystems will include as a standard process external access that does notrequire specialized training or skills in each system, to makeinformation available to other HCPs.

The method of accessing and displaying information would be contained inthe repository database of HCPs. If a requesting HCP wants to seedetails from a treatment record, the repository would act as atranslator to make the information available in readable and accessibleform. The exact format of record display and the methods available andemployed by HCP record systems are expected to change and improvecontinually, but those changes would not affect the method employedherein because the method contemplates many different systems, havingmany different display methods.

Once a search has been performed by the requesting HCP and a list ofavailable records displayed (steps 1-4 in the process above), a furtherprocess would be employed, as follows:

For each record, allow HCP to access or request information: (a)Directly into medical records system, if available, from the previousHCP; (b) Browser based display of information in standard format fromprevious HCP; (c) Request form to be forwarded to HCP requesting Fax orprinted copies of medical records; and (d) Telephone and fax numbers ofprevious HCP if no other means of record retrieval available.

Referring now to FIG. 2, there is illustrated the various ways in whichHCP update patient information to the Repositories for the creation ofrecord pointers by the Respositories. Each of the Healthcare Providers(HCPs) from FIG. 1, is a subscriber or customer of Repositories A (120),N (150) or V (180), of many possible Repository Services Providers. EachHCP in the examples of this embodiment of the invention uses a differentmethod to inform the Repository of patient records available in someform from the HCP. Northwestern Hospital (130) links (136) their recentelectronic records management system directly to the repository, andallows for direct access to record information or images through therepository by other HCPs that may be treating a patient. Northwestern(130) also has in this example stored older records with the repositoryusing a service provided by the repository. Dr. Smith (160) has adirectly accessible system and updates the repository with patientrecord pointers daily (168). Dr. Kastner's (170) office uses an offlineprocess to manually record information to upload to the repository(175), while Dr. Vaughn (192) indicates (195) the availability ofrecords that could be mailed or faxed. As one possible convention, anHCP can indicate that many patient records are available by indicating apatient ID and the last service date, leaving the diagnostic or billingcode blank.

Referring now to FIG. 3, there is shown an example of a request forpatient record information by a Healthcare Provider 200 to a repository210, and an example response. Upon receiving a request, the Repositoryconducts a search query 220 through its own records and through otherrepositories, if necessary. A response 230 to the search query isgenerated by the Repository and is either sent to the HCP oraccessible/viewable by the HCP through a dedicated network. The responsewould include pointer records 232, 234, 236, 238. Each pointer recordrepresents a medical record stored either on a repository 210 or at aHCP. Furthermore, each pointer record would typically include an HCPidentification number 242, date of service 244, diagnostic or billingcode 246, and the availability status 248. The availability statusprovides the searcher with information on how to retrieve the medicalrecord. The response 230 may also provide for the ability for expandedinformation 250, based on the data base of HCP diagnostic or billingcodes and indicators for record availability.

Based on the above disclosure and drawings, there is provided herein oneor more embodiments for creating and accessing patient medicalinformation in a network. In one embodiment there is provided arepository database storing medical records of a plurality of patients.Each medical record would be associated with a healthcare provider andfurther includes a healthcare provider identification code, a date ofservice, a diagnostic or billing code, and an availability code listingthe access of the medical record with the respect to the healthcareprovider. A search processor is included for initiating, in response toa first command, a search of the repository database to locate at leastone medical record associated with a particular patient. In addition, aninterface processor is included for generating in response to a secondcommand, a request to access the stored medical record of the particularpatient. The response to the second command would include at least oneof the following: a link to the actual medical record being stored onthe repository database, or direct contact information associated withthe healthcare provider. To separate the medical records efficiently,each patient, of the plurality of patients, is associated with a patientidentifier. In this embodiment the direct contact information associatedwith the healthcare provider would either be a telephone number, email,or facsimile number.

In other embodiments, there would be provided a plurality of repositorydatabases, each storing medical records of a plurality of patients, andwherein the search processor for initiating, in response to the firstcommand, searches the plurality of repository databases, to locate allmedical records associated with the particular patient.

In another embodiment there would be provided a system for accessingpatient medical information in a network that included a plurality ofrepository databases storing medical links. Each medical link would beassociated to a medical record. The medical link includes a healthcareprovider identification code, a date of service, a diagnostic or billingcode, and an availability code listing the access of the medical recordwith the respect to the healthcare provider. An interface processorwould be provided for generating a medical link in response to ageneration command initiated by a healthcare provider having access toone or more of the repository databases, and wherein the generation ofthe medical link creates an availability code for the medical record,from one of the following: (a) a hyper-link to the medical record beingstored on one of the repository databases, (b) a hyper-link to themedical record being stored on a healthcare provider database, or (c)non-networked direct contact information to the healthcare provider. Inaddition thereto, when the availability code indicating the medicalrecord is non-networked direct contact information to the healthcareprovider, the availability code further includes information associatedwith the healthcare provider such as but not limited to a telephonenumber, email, or facsimile number.

In view of the above, it will be seen that several advantages of thepresent invention have been achieved and other advantageous results havebeen obtained. From the foregoing and as mentioned above, it will beobserved that numerous variations and modifications may be effectedwithout departing from the spirit and scope of the novel concept of theinvention. It is to be understood that no limitation with respect to thespecific methods and apparatus illustrated herein is intended or shouldbe inferred.

The below represents source code that exemplifies the system byoutlining and performing various functions including: (a) acceptingupdates from automated HCPs in the form of an XML file, a standardexchange method (others of course possible); (b) accepting updatesthrough a web interface where an HCP would enter the informationdirectly (non-automated HCPs); (c) providing updates to otherRepositories using the XML file format, other methods of coursepossible; and (d) and allowing an HCP to query the repository file andsee all records for a specific patient.

The below SetupandTestDB.java routine creates sample versions of thethree main data bases used in the Repository NManager process: RepDB hasHCP records by patient, date of service and diagnostic code; HCPDB isused to expand HCP codes to HCP names; DiagCodeDB is used to expanddiagnostic codes.

The below BrowserDriver.java code outlines the method of acceptingrecords entered online and adds the record pointer file. It furtherselects records from the Repository database based on patient ID anddisplays the results in a list.

The below SQLDrivers.java code implements SQL rountines to add recordsto the database and select records from the database based on a patientID.

-   package RepDemo;-   import java.sql.Connection;-   import java.sql.DriverManager;

1. A computer-based system for accessing patient medical information ina network comprising: a plurality of healthcare provider computingdevices storing detailed medical records about a plurality of patients,a first of said plurality of healthcare provider computing devicesconfigured and arranged to generate and upload a first set of medicalrecord pointers to a repository computing device, a second of saidplurality of healthcare provider computing devices configured andarranged to generate and upload a second set of medical record pointersto said repository computing device, said medical record pointersincluding summary information sufficient to locate detailed medicalrecords about one or more patients, without including the entiresubstantive content of said detailed medical records themselves; arepository database residing on said repository computing device, saidrepository database storing medical records of a plurality of patientsgenerated at least in part from said first and second set of medicalrecord pointers, each medical record, being associated with a healthcareprovider, further includes a healthcare provider identification code, adate of service, a diagnostic or billing code, and an availability codelisting an ability to access the medical record with the respect to thehealthcare provider; a search processor, including at least one computerhardware component, for initiating, in response to a first command, asearch of said repository database to locate at least one medical recordassociated with a particular patient; and an interface processor,including at least one computer hardware component, for generating inresponse to a second command, a request to access said stored medicalrecord of the particular patient, which said response to said secondcommand includes at least one of the following: a link to the actualmedical record being stored on said repository database, or directcontact information associated with the healthcare provider; wherein atleast one of said plurality of stored medical records has anavailability code indicating that the stored medical record is availablein direct form online, at least another of said plurality of storedmedical records has an availability code indicating that a browser-baseddisplay of the stored medical record is available in a standard format,and at least still another of said plurality of stored medical recordshas an availability code indicating that a request form must besubmitted to the associated healthcare provider so as to request that afaxed or printed copy of the stored medical record be sent.
 2. Thecomputer-based system of claim 1, wherein each patient, of the pluralityof patients, is associated with a patient identifier.
 3. Thecomputer-based system of claim 1, wherein direct contact informationassociated with the healthcare provider includes either a telephonenumber, email, or facsimile number.
 4. The computer-based system ofclaim 1 further comprising: a plurality of repository databases, eachstoring and exchanging medical records of a plurality of patients witheach other repository database, and wherein the search processor forinitiating, in response to the first command, searches a repositorydatabase, of the plurality of repository databases, to locate allmedical records associated with the particular patient.
 5. Thecomputer-based system of claim 1, wherein the diagnostic or billingcodes are linked to detailed information in the medical record, suchthat the interface processor upon the request to access said storedmedical record of the particular patient, retrieves the detailedinformation for display.
 6. A computer-based system for accessingpatient medical information in a network comprising: a plurality ofhealthcare provider computing devices storing detailed medical recordsabout a plurality of patients, a first of said plurality of healthcareprovider computing devices configured and arranged to generate andupload a first set of medical record pointers to a first repositorycomputing device, a second of said plurality of healthcare providercomputing devices configured and arranged to generate and upload asecond set of medical record pointers to a second repository computingdevice, said medical record pointers including summary informationsufficient to locate detailed medical records about one or morepatients, without including the entire substantive content of saiddetailed medical records themselves; a plurality of repositorydatabases, a first of said plurality of repository databases residing onsaid first repository computing device and a second of said plurality ofrepository databases residing on said second repository computingdevice, each of said plurality of repository databases storing medicallinks generated at least in part from said first and second set ofmedical record pointers, each medical link being associated to a medicalrecord, the medical link including a healthcare provider identificationcode, a date of service, a diagnostic or billing code, and anavailability code listing an ability to access the medical record withthe respect to the healthcare provider; and an interface processor,including at least one computer hardware component, for generatingmedical links in response to a generation command initiated by ahealthcare provider having access to one of the repository databases,wherein the generation of medical link creates availability codes formedical records depending on the manner in which the medical records arecapable of being accessed, and wherein the creation of availabilitycodes includes creating each of the following: (a) a first availabilitycode indicating that at least one of said medical records is availablein direct form online, (b) a second availability code indicating that abrowser-based display of at least another of said medical records isavailable in a standard format, and (c) a third availability codeindicating that, in order to access at least still another of saidmedical records, a request form must be submitted to the associatedhealthcare provider so as to request that a faxed or printed copy of themedical record be sent.
 7. The computer-based system of claim 6, whereinthe third availability code further includes information associated withthe healthcare provider further includes information associated with thehealthcare provider comprising at least one of the following: (i) atelephone number, (ii) email, or (iii) facsimile number.
 8. Thecomputer-based system of claim 7, wherein said interface processorfurther generates in response to a second command, a request to accessat least one medical record associated with a particular patient, whichsaid response to said second command includes at least one of thefollowing: a link to the actual medical record being stored on saidrepository database, or direct contact information associated with thehealthcare provider.
 9. The computer-based system of claim 7 furthercomprising: a search processor for initiating, in response to a firstcommand, a search of one of said plurality of repository databases tolocate at least one medical record associated with a particular patient;and wherein said interface processor further generates in response to asecond command, a request to access said at least one medical record ofthe particular patient, which said response to said second commandincludes at least one of the following: a link to the actual medicalrecord being stored on said repository database or stored on saidhealthcare provider database, or direct contact information associatedwith the healthcare provider.
 10. The computer-based system of claim 6,wherein each of the repositories, includes an updating processor forcommunicating and updating with other repositories medical linksgenerated thereon.
 11. The computer-based system of claim 1, whereinsaid first of said plurality of healthcare provider computing devices isconfigured and arranged to access said detailed medical records aboutone or more patients residing on said second of said plurality ofhealthcare provider computing devices by means of said repositorycomputing device.
 12. The computer-based system of claim 6, wherein saidfirst of said plurality of healthcare provider computing devices isconfigured and arranged to transmit healthcare record information tosaid second of said plurality of healthcare provider computing devicesby means of said first and second repository computing devices.
 13. Thecomputer-based system of claim 6, wherein said first repositorycomputing device is configured and arranged to exchange said medicallinks with said second repository computing device.
 14. A computer-basedsystem for accessing patient medical information in a networkcomprising: a plurality of healthcare provider computing devices storingdetailed medical records about a plurality of patients, a first of saidplurality of healthcare provider computing devices configured andarranged to generate and upload a first set of medical record pointersto a first repository computing device, a second of said plurality ofhealthcare provider computing devices configured and arranged togenerate and upload a second set of medical record pointers to a secondrepository computing device, said medical record pointers includingsummary information sufficient to locate detailed medical records aboutone or more patients, without including the entire substantive contentof said detailed medical records themselves; a plurality of repositorydatabases, a first of said plurality of repository databases residing onsaid first repository computing device and a second of said plurality ofrepository databases residing on said second repository computingdevice, each of said plurality of repository databases storing medicallinks generated at least in part from said first and second set ofmedical record pointers, each medical link being associated to a medicalrecord, the medical link including a healthcare provider identificationcode, a date of service, a diagnostic or billing code, and anavailability code listing an ability to access the medical record withthe respect to the healthcare provider; and an interface processor,including at least one computer hardware component, for generatingmedical links in response to a generation command initiated by ahealthcare provider having access to one of the repository databases,wherein the generation of medical links creates availability codes formedical records depending on the manner in which the medical records arecapable of being accessed, and wherein the generation of medical linksincludes generating each of the following: (a) a hyper-link to a firstmedical record being stored on one of the repository databases, (b) ahyper-link to a second medical record being stored on a healthcareprovider database, and (c) non-networked direct contact information fora healthcare provider having a third medical record that is not directlyaccessible by electronic means.
 15. The computer-based system of claim14, wherein each of the repositories, includes an updating processor forcommunicating and updating with other repositories medical linksgenerated thereon.
 16. The computer-based system of claim 14, whereinsaid first of said plurality of healthcare provider computing devices isconfigured and arranged to access said detailed medical records aboutone or more patients residing on said second of said plurality ofhealthcare provider computing devices by means of said first and secondrepository computing devices.
 17. The computer-based system of claim 14,wherein said first repository computing device is configured andarranged to exchange said medical links with said second repositorycomputing device.